To deworm or not to deworm?

The World Health Organization recommends large-scale drug management every year in soil-borne worms (aphids, hookworms, and whipworms) (STH) infected by 20% of school-aged children. These parasites live in the human intestine, spread through eggs in feces and hatch in larvae to find the next host soil. They cause a series of symptoms and are associated with poor cognitive abilities, stunning and anemia

Determining whether a person has an STH is done by examining the presence or absence of eggs in the stool sample.

It requires unique technical skills and takes time. Diagnosis is expensive, and on a large scale it is difficult to handle, thus using large quantities of albendazole (MDA). Albendazole removes insects with minimal side effects, but large-scale treatment implies that both infected and uninfected people receive treatment and increases the cost of this intervention.

Research showed that 1 GBP treatment can bring about a profit of £ 6. These benefits include personal health benefits such as decreased anemia and malnutrition. In addition, it is thought that anthelmintism potentially improves the number and enrollment of enrollment and improves adulthood productivity. In addition, insects can reduce pressure on the medical system by treating common infections.

Individuals and communities can benefit from treatment, but there is unresolved argument as to whether large scale disinfection should be continued or not. A preliminary survey was systematically reviewed to provide policy advice based on evidence as to whether the Cochrane review was established and MDA is most effective

A large scale anthelmintic review found that limited evidence of regular antiparasitic treatments could improve mean weight gain, hemoglobin or cognitive function. This raises a question as to whether quality improvement is the best strategy.

However, the new meta-analysis includes more research than cochrane research, and in fact it found a positive effect of worm removal. The authors also show that antiparasitic agents gain weight more effectively than school meal programs (36 times per dollar)

Whether or not to use limited resources in the MDA program has been debated until discussion is limited. It is expected that the burden on individuals and local communities will be reduced by large-scale disinfection and the epidemic will eventually decline. As we move forward, it is important to optimize the management of these diseases and to identify important measures to monitor and plan specific interventions.

The latter research group such as insect repellant research provides cost-effective evidence to persuade the government to do these interventions. As we all know, students have worms and insect repellent to make them feel depressed. The problem is that the government is not working so hard to complete the job. Studies to reduce worms showed that low cost can increase registration rate by reducing worms. And I urge the government to take action. Second, the effectiveness of intervention is a combination of "technical know-how" and "implementation ability". The ability to implement also depends on the complexity of "technical know-how". If the implementation capacity is low, care must be taken to implement the initiative to be implemented. The first step is to take action that shows prospects at least in the context of strong interventions. In other words, this intervention is good at "technical know-how".

In the past few years, support for worm removal continues to increase. Charity group evaluator GiveWell advises donors to donate to Deworm the World and Schistosomiasis initiatives based on the strength of evidence from large scale disinfection programs. However, the first serious problem of evidence was revealed in 2012. At that time, Cochrane Collaboration, a group systematically reviewing the evidence for research testing established a review that scarcely found evidence to support massive worm elimination. "Our interpretation of these data suggests that evidence based on the consistent benefits of nutrition, hemoglobin, school or school performance is not enough to know whether this is a reliable message, so it is not sufficient for modern worm disinfection programs Author who proves that rationality can be misleading